Strange Question

Hello Robyn and thanks for fielding the difficult questions. It is a very tough issue to get our heads arounds & I’ve asked many of the same questions… as I wanted desperately at the time of Dad’s diagnosis (Nov. 08) to know how this was all going to unfold. I too simply couldn’t reconcile how a strong healthy person could be handed such a sentence. CC felt like an unwanted intruder in our lives, that with enough research, experts & support, we could push back out the door. I’ve learned from the countless hours on this board that each case is different. I asked a best friend how cancer kills & she said that in her experience, the pain meds slowly take such a toll on the heart, that it eventually stops. With Dad, he did wake one eve with chills/fever & an infection that had spread through his blood stream. They caught it in time & he was ok, but it was very serious. The chemo has made him very weak & his immune system is down, this compromises his health & makes him susceptible to other germs. The radiation, which he will begin next week will destroy one kidney & part of his lung… at best, per the docs. However, if he doesn’t pursue it- in hopes of shrinking to size of resection, the cc will surely take him.

The tumor itself has been indirectly related to all the complications to date & those to come, but in and of itself- has served as a secondary source of all setbacks.

I also believe that the common threads that bind those with cc are yet to be understood. I worry about genetics, in that my son now has two grandfathers – on both sides of his genetic pool, with cc. His other Grampa passed in 98 from cc complications associated with resection.

You and your Mom are in our thoughts Robyn. I know it’s not easy, she’s lucky to have you!

Tess

I think you can live with a tumor for a long time with no problems…but it depends on the type of cancer. My friend’s father has prostate cancer and he takes medicine for it and it is basically a chronic disease and not life threatening. CC is different, but how different is individual. Jeff, didnt you live with your tumor for about 4 or 5 years before doing anything with it? I could be remembering that wrong, but I think that is the case.

Kris

Please clarify me if I’m wrong (I know there are much better experts than me out there), but I was under the impression that the liver can keep going at a very low capacity, but it’s the kidneys that shut down because they are so dependent on the liver, so it’s actually kidney failure that happens before liver failure. I think that’s what a doctor told me (in a much more logical and scientific way). Also, I had heard about infections being a natural part of the process, as a few people said. And some tumors just start growing incredibly quickly.

I feel terrible — being so clinical about this, but it’s an interesting question and something we need to understand in order to beat this disease. Thanks for bringing this up, Robyn, and all my best wishes to you, your mom and your family.

Joyce M

If the tumor simply sits there and does not encroach on vital organs couldn’t we assume that a person could live with it? I often wonder as to why some people diagnosed with CC respond so well to chemotherapy whereas others simply do not respond at all. I have been told that chemotherapy can only penetrate tumors up to 3 or 4 centimeters therefore, the debulking of the tumor can be considerationfor some patients. And what about those patients who respond well to one of the more common drugs and, that for years? Charles R. Thomas and Clifton Fuller’s book: “Biliary Tract and gallbladder cancer” describe the distinction from liver cell cancer amongst other lies in the following: A prominent desmoplastic stromal reaction and mucin production are key features in favor of a tumor being a cholangiocarcinoma. And it goes on to say: The presence of definite biliary dysplasia is potentially very useful, but in practice is rarely seen and can be very difficult to distinguish from reactive biliary changes seen as the result of obstruction due to any kind of tumor. The book continues to describe for CC to be positive for biliary cytokeratins (CK7 and CK19) while they are less frequently expressed by liver cell cancers, although in some series up to 50% are CK7 positive.

There are so many questions in re: to this cancer although, I believe that in the future most of these disease will be genetically distinguishable.
Point to ponder for the day,
Hugs to all,
Marion

Robyn

I was told by my surgeon, after being told that surgery was no longer an option, that it would likely be an infection that would ultimately kill me. I would guess at it being pneumonia if the tumours metastise to my lungs. But I daresay all options are still available.

Ron